Fundamentals exam #2
1. Describe the inflammatory process
Cellular injury = acute inflammation (sometimes leads to healing depending on the size of the
wound)
Chronic inflammation = (sometimes leads to healing depending on the size of the wound)—
Granuloma formation = healing
2. What types of patients are susceptible to infection
Patients who are of older age , patients who suffer from poor nutritional health, patient who
suffer from major amounts of stress and patients who suffer from diseases that makes them
become immunosuppressed. New borns
3. Define medical and surgical asepsis
Medical Asepsis = Clean - Reduces or inhibits number and growth of microorganism (Hand
washing)
Surgical Asepsis = Sterile - Eliminates all organisms, both pathogenic and non-pathogenic,
including spores
4. What are the stages of infection?
Incubation Period
Interval between entrance of pathogen into body and appearance of first symptoms (e.g.,
chickenpox, 2-3 weeks; common cold, 1-2 days; influenza, 1-3 days; mumps, 15-18 days)
Prodromal Stage
Interval from onset of nonspecific signs and symptoms (malaise, low-grade fever, fatigue) to
more specific symptoms (During this time, microorganisms grow and multiply, and client may be
more capable of spreading disease to others)
Illness Stage
Interval when client manifests signs and symptoms specific to type of infection (e.g., common
cold manifested by sore throat, sinus congestion, rhinitis; mumps manifested by earache, high
fever, parotid and salivary gland swelling)
Convalescence
Interval when acute symptoms of infection disappear (Length of recovery depends on severity of
infection and client's general state of health; recovery may take several days to months)
5. What are the lab values that indicate infection
WBC count, iron level, cultures of urine and blood, cultures and gram stain of wound and
different types of WBC’s
, 6. Discuss various types of isolation and which organisms would require what type of isolation
Airborne = chickenpox, measles, TBD
Droplet = influenza
Contact = MRSA , VRE
Protective environment = the prevention of exogenous microorganism from the nurse to be
spread onto patient who may be immunocompromised
What are the chains or links of infection (susceptible host, portal of exit, portal of entry, etc?)
Mode of transmission = unwashed hands, uncleaned bp cuff, uncleaned stethoscope
Portal of entry = organisms that exit the body the same way they leave the body
Host = depends on the individuals resistant to the pathogen
7. What is necessary to support good wound healing?
Control bleeding, Allow puncture wounds to bleed, Do not remove a penetrating object,
Bandage, Cleaning, Gentle, Normal saline, Protection (dressing)
Nut\trition = vit a , vit c , protein
Tissue perfusion = oxygen fuels celluar
8. What are the stages of decubiti?
Stage 1: skin red & unbroken
Stage 2: skin with epidermal and dermal injury
Stage 3: subcutaneous tissue is broken
Stage 4: muscle, tissue and bone visible
How does the nurse prevent them?
Rotating the patient q2h, adequate nutrition, prevention of friction and shearing.
Who is at risk for development of a decubiti/pressure ulcer?
Elderly patients and patients who are bedridden or immobilized
How does the nurse asses a patient for risk of pressure ulcer development?
Exam their mobility, check skin integrity, nutrition status, body fluids, pain care
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